Prescription opioids, heroin go hand-in-hand

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November 22, 2013 at 2:48 pm

Tom West, West Words

Bad things happen to people who use heroin. Most people in Morrison County know that. A couple of weeks back, a Minneapolis drug dealer was convicted of third degree murder for the heroin overdose of a Little Falls woman almost two years ago.

The message didn’t get through to everyone. Last week, a Little Falls man was charged with heroin distribution.

Morrison County Sheriff Michel Wetzel said we need to arrest the dealers and put them in prison. However, that only addresses the supply side of the problem. It’s the demand side that remains most troubling. Luckily, your intrepid editor got a chance to talk to someone who understands that side of the drug issue.

Last week, the ECM Editorial Board met with Carol Falkowski of Drug Abuse Dialogues. She has more than 30 years experience in the addiction field, including 10 years at the Hazelden Foundation, as well as two stints with the Minnesota Department of Human Services, during the latter of which she served as director of the Alcohol and Drug Abuse Division.

In case you were wondering, the state spends $140 million annually fighting these addictive chemicals.

However, Falkowski said we are now moving into uncharted territory. The drug landscape has changed markedly over the last five years.

One good sign is that teenage drinking and driving while intoxicated have decreased, resulting in fewer car accidents. The bad news is that instead of having a beer and going on a joy ride, more kids are into binge drinking at parties, so more kids are dying from alcohol poisoning.

Smoking of tobacco has also decreased, but again the news is mixed. Smoking of marijuana among teens is now more frequent than smoking tobacco. Falkowski said that a study found that people who meet the criteria for addiction to marijuana on average lose eight IQ points by age 38. “I’m convinced the world is stupid enough already,” she said, voicing opposition to legalizing pot.

Another new development is that direct consumer advertising of illicit drugs online is greater than ever.

Falkowski noted that the use of meth peaked in 2005, and has been declining ever since. However, the past decade has seen a slow but steady growth in addiction to prescription opioids and heroin. That’s because prescription opioids (aka pain killers) and heroin affect the brain in the same way. Today, more than 20 percent of the addicts entering treatment are there because of prescription opiates or heroin.

Falkowski said that 80 percent of the opioids in the world are used in the United States, and that 14 percent of the U.S. population reports non-medical use of opioids. Seventy percent of kids will use alcohol before they get out of high school, and now 20 percent will use prescription painkillers.

So who is getting hooked on prescription opioids? It’s not the down-and-outers, necessarily, or teen runaways. It can be accident victims who are given pain medication while their injuries heal. Falkowski reported one case where two boys, ages 18 and 19, took turns throwing themselves out of a moving vehicle at 20 or 30 miles an hour. They weren’t going fast enough to be killed, but fast enough to injure them enough so the physician would prescribe pain pills for them.

Other candidates for addiction are people who have a knee or hip replacement. Falkowski reported that a middle-aged woman hooked on painkillers went to garage sales, just so she could ask to use the bathroom, and then steal any pain killers she found.

Falkowski said, “This is unlike any other drug problem. We can’t get out of it without looking at how we practice medicine.”

Indeed, hydrocodone with acetaminophen was the most frequently prescribed drug in Minnesota in April, accounting for 22 percent of all prescriptions. Oxycodone with acetaminophen accounted for 8.9 percent and oxycodone hydrochloride for an additional 7.1 percent. Those painkillers alone accounted for 38 percent of all prescriptions filled.

Make no mistake, pain killers are needed in some instances, but the problem is that in too many cases they are leading to addiction long after the original problem has disappeared.

She said medical schools are not giving doctors enough training in recognizing the signs of addiction. Doctors are also sometimes put in a bad place. She said that one rural Minnesota doctor told her that he gets his life threatened once a month for refusing to fill prescriptions.

So what can be done? The DARE program, once popular in schools, has been found to be ineffective in preventing drug abuse. Falkowski called for a more comprehensive approach, involving families, schools and communities.

Don’t expect the schools to solve a problem that affects all ages, and don’t expect the problem to go away by itself. The chemical pull of these drugs is too strong, so we need to raise everyone’s awareness that even legally-prescribed drugs given with the best of intentions, need monitoring not only by physicians, but friends and family as well.

Tom West is the editor and general manager of the Record. Reach him at (320) 616-1932 or email t[email protected].